In 1846, Viennese physician Ignaz Semmelweis observed that women whose babies were delivered in the First Clinic at the General Hospital of Vienna consistently had a higher mortality rate than women whose babies were delivered by midwives at the presumably less reputable Second Clinic. Dr. Semmelweis noted that physicians delivering babies in the First Clinic often came directly from performing autopsies, and their hands carried “disagreeable odors” that may have been caused by the presence of “cadaverous particles.”

The good doctor prevailed upon his peers to bathe their hands in a chlorine solution between the autopsy room and maternity ward, and voila, the mortality rate in the First Clinic dropped sharply. This was the first known instance where hand-washing with an antiseptic agent between treating patients reduced the transmission of infectious agents.

Fast forward to 1975 when the Centers for Disease Control and Prevention (CDC) published its first, formal written guidelines on hand-washing procedures in hospitals. Nearly 40 years following these guidelines, the CDC – along with several professional organizations – is still leading the charge to make sure health-care professionals take the simple step of washing their hands.

Just as in mid-19th century Vienna, the stakes are still large. Infections associated with health-care, whether in hospitals, nursing homes or doctors’ offices, affect more than 1.7 million people in the U.S. each year and are linked to nearly 100,000 deaths, according to the CDC. These infections cost the health-care system between $35 and $45 billion annually.

Yet compliance by health-care professionals with hand-washing guidelines is still spotty, and patients are often reluctant to ask physicians and nurses to wash their hands before being examined.

Despite nearly 40 years of campaigns by the CDC and professional organizations, studies compiled by the University of Geneva show that hospital staff, including doctors, nurses, nursing assistants, etc., comply with hand-washing protocols only about 50% of the time on average.

So should you ask your doctor to wash his hands?

The CDC says yes, and they, along with the Association for Professionals in Infection Control and Epidemiology, are actively promoting the practice through publications, posters and videos for patients and health professionals alike.

For example, the CDC has provided 16,000 copies of a video, “Hand Hygiene Saves Lives,” to show patients at admission. After the video was shown to patients in 17 health-care facilities, patients were twice as likely to report reminding nurses to wash their hands and doctors were twice as likely to report being asked by patients to do the same.

According to a study published recently in the American Journal of Infection Control, 84% of parents of hospitalized children were aware of infection risk, yet only two-thirds would remind health-care workers to wash their hands. The greatest barrier appears to be unwillingness to confront authority. However, more than 90% of parents would be more likely to speak up about hand-washing if they were invited to do so. A number of health-care organizations are now displaying posters and buttons that invite patients to request their caregivers to wash their hands.

So don’t be afraid to speak up when visiting your doctor. I suggest saying something like, “I’ve read about the importance of hand-washing between patients. Do you mind washing your hands before we proceed?” If your doctor or other health-care provider is resistant, look for another provider.